Provider Demographics
NPI:1245069327
Name:RESTORATIVE SLEEP MEDICINE
Entity type:Organization
Organization Name:RESTORATIVE SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-BC, DBSM
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WERMTER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:434-202-4199
Mailing Address - Street 1:125 RIVERBEND DR STE 2
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8695
Mailing Address - Country:US
Mailing Address - Phone:434-202-4199
Mailing Address - Fax:
Practice Address - Street 1:125 RIVERBEND DR STE 2
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8695
Practice Address - Country:US
Practice Address - Phone:434-202-4199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic